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lare of the foot 



MLLIAM AWOODBURY 




Book /r^^ 

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COFfRIGKT DEPOSIT. 



THE 

CARE OF THE FOOT 

A Practical Text-hook on Chiropody and 
General Care of the Foot 

FOR PROFESSIONAL AND PRIVATE USE 



BY 

WILLIAM A. WOODBURY 

DERMATOLOGIST 
AT7TH0R OF "bEAUTY CULTURE," "tHE CARE OF THE HAIR AND SCALP,' 

"hair dressing and tinting," "the care of the hand," 

"the care of the face," "how to get thin and 

how to acqihre plumpness," etc. 



Nay, her foot speaks. 

— Shakespeare. 



G. W. DILLINGHAM COMPANY 

PUBLISHERS NEW YORK 



■Wgs 



Copyright, 1915, by 
WILLIAM A. WOODBURY 



e Care of the Foot 



M\~\ 1915 :#^^^^ 

©CI,A406104 



^ 



CONTENTS. 
INTRODUCTORY 

PAGE 

CHAPTER I— ANATOMY OF THE FOOT . . 7 

Expressiveness of the Foot — Racial Characteris- 
tics — Structure of the Foot. 

CHAPTER II— SHOES 15 

Ancient Shoes — The Sandal, the Buskin — The 
Moccasin — The Chinese Shoe — The Chiropodist as a 
Shoe Expert — Meyer's Reformation in Shoe Con- 
struction — Characteristics of a Proper Shoe — Chil- 
dren's Shoes. 

CHAPTER III— CARE OF THE FEET ... 29 

Change of Shoes and Stockings — Bathing — Nail 
Trimming — Advice for Patrons. 

CHAPTER IV— CHIROPODY ..... 34 

The Necessary Instruments — Preparation of the 
Feet — Treatment of Hard Corns: By Knife Alone; 
Medicinal Method — Inflamed Hard Corns — Soft 
Corns — Vascular Corns — Removal of Callosities 
— Treatment of Ingrowing Nails — Of Bunions — 
Recipes — Treatment of Flatfoot — Artificial Arches — 
Treatment of Chilblains — Recipes — Treatment of 
Perspiring Feet — Recipes — Treatment of Hot Feet 
and Cracks Between Toes. 



INTRODUCTORY. 

Style and Comfort are not necessarily synonymous 
terms, but it is safe to state that a very great deal of 
the discomfort caused by shoes is not the fault of the 
style. 

Many young persons and some not so young find it 
hard to accept a shoe quite long or wide enough. 
"While many older persons who have realized the folly 
of their earlier notions, make the less painful and seri- 
ous mistake of selecting shoes that are unnecessarily 
large. 

It is the business of this little book to show in a 
simple, practical manner how the more common ail- 
ments of the foot may be overcome. In New York 
State a Regent's license is necessary to become a prac- 
ticing chiropodist, so that a working knowledge of 
the care of the feet is no mean accomplishment for 
anybody. 

Just what would happen if the feet were left free 
and unhampered we do not know. Adam and Eve 
are pictured with bare feet, but almost every bit of 
knowledge we have of man shows him with some sort 
of foot protection — and apparently this is the result of 
well defined necessity, and not all style, for do we 
not shoe horses and other animals when pressed into 
regular daily service? 

The shoes that are made now here in America are 
probably more nearly than ever before adapted to the 
shape of the foot and the use that is expected of both 
the shoe and the foot. 



Introductory 



That people do have corns and bunions and ingrow- 
ing nails and flat feet is not direct evidence against 
the shoes so much as it is that the wrong shape or 
size was worn. 

I do not believe it is necessary for comfort or safety 
to wear some of the homely shoes we have been told 
are the only thing. Nor do I believe "style" or a 
pretty foot require some of the shapes that are made 
to sell. 

The whole secret seems to be in selecting a shoe and 
for that matter a stocking that fits — the stocking 
rather snugly and the shoe snug enough when first put 
on to be free all around when worn a while without be- 
ing even a little bit loose. "Breaking in" shoes is 
no longer necessary, as they can now be bought the 
shape and size for the foot that is to wear them and 
worn the day they are bought. 

Whether you prefer so-called French, Cuban, Mili- 
tary, or Flat Heels, or no heels at all, is not so impor- 
tant from the standpoint of beauty as it is that they 
be a shape and height that will enable you to get about 
safely, gracefully and comfortably, and that they be 
kept in good condition. 

For summer wear the shoes and stockings selected 
should be a trifle wider than for cold weather, as the 
feet are likely to swell. If the foot is stocky, select a 
shoe a size or two longer than you really need — no- 
body objects to a long foot. 

See that the shoes are neat and trim about the ankle. 
Only in extreme cases need shoes be fashioned to fit 
a deformity. Suflicient width of sole for displaced 
joints or for bunions is the obvious selection. 



THE FOOT 

CHAPTER I. 
ANATOMY OF THE FOOT. 

Expressiveness of the Foot — Racial Characteristics — 
Structure of the Foot. 

In its natural undistorted condition, the foot is almost 
as beautiful and expressive a member as the hand. It 
can be trained to do wonderful things. A ballet dancer, 
such as Fannie Elsler, whose music of motion extorted 
the ejaculation *'divine" from the Concord philosopher, 
Ralph Waldo Emerson, reveals the marvellous strength 
and pliability which the foot may acquire by assiduous 
cultivation. Even in its ordinary function of walking, 
the foot's capacity for expression strikes the eye. Virgil 
makes her gait the most significant sign of the goddess 
of beauty, Venus : 

"And the true goddess is shov/n by her going." 

Furthermore, the foot may be trained to do many 
things that would seem utterly outside its particular 
province. Men and women who have lost the use of 
their hands have learned to write with their toes, to 
sew and to embroider. To box with the feet in con- 
nection with the head and fists, is not an uncommon ac- 
complishment among Frenchmen. It is called the savate. 

7 



The Care of the Foot 



Racial Characteristics. — Races are markedly dis- 
tinguished by differences in character of the foot. The 
EngHsh foot is rather fleshy, but short and not so strong 
as it should be. The Scotch foot, high and thick, shows 
power and endurance. 

The French foot is recorded as long, narrow, and well 
proportioned. 

The Russian foot is peculiar in that the skin between 
the toes is generally webbed to the first joint. The Tar- 
tar has toes of equal length. 

The Mexican Indian foot is quite short and strong, 
with a noticeable distance between the great and second 
toes. 

Savage tribes, such as the Mexican peons (now a 
gentle, industrious people) were a few centuries ago, 
usually show a decided distance between the great and 
second toes, undoubtedly due to the spreading of these 
parts in climbing trees. 

The feet of Americans are well formed, but inclined 
to be too short for the height of the individual, especially 
in women. 

The length of the foot of a woman five feet and six 
inches tall should be nine and one-third inches. Such 
a foot should not be thick and heavy, but slender and 
of delicate look, though firm of skin and with a well- 
defined arch at the instep that should be rather more 
marked than that of a man. 

Structure of the Foot. — ^The human foot may be 
truly said to be of a higher order than that of any of 
the so-called lower animals in that it is constructed not 
only to give ease to every poise and movement of the 
body, but to bear this weight gracefully and to add by 
its own movements, as well as its own shape, to the 
grace or beauty of the individual. 




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fi&rATARiAt-i 



'Fha.u^j^^^eS 



Fig. 23 
THE ANATOMY OF THE FOOT 



lo The Care of the Foot 

"Her feet beneath her petticoat 
Like little mice played in and out'* 

sings the old English poet, Sir John Suckling, who un- 
derstood the esthetic quality of feet as well as any phys- 
iologist appreciates their structural perfection. 

Twenty-six bones, beautifully arranged, bound up to- 
gether by ligaments and muscles and permitting more or 
less motion on one another, are found in the foot. (See 
Figure 23.) 

The motion is chiefly on its outer or toe division and 
comparatively little behind the ball. Of these bones, 
fourteen may be said to belong to the toes, the rest com- 
posing the formation of the tarsus. 

Of these fourteen toe bones, the great toe has two, 
the other toes three each. Back of the toes are the five 
metatarsal bones, numbered from the great toe one to 
five, making up the anterior of the arch. 

The seven tarsal bones are especially named: 

1. Os Calcis. 4. Cuboid 

2. Astralagus. 5. Internal Cuneiform. 

3. Scaphoid. 6. Middle Cuneiform. 

7. External Cuneiform. 

The last four of these make up the posterior of the 
arch. The anklebone (astralagus) is clasped on each side 
by the malleolus, a projection from the leg, forming what 
is called the ankle joint. 

Architecturally studied on its inner aspect, the arch 
is found to rest in front on the anterior heads of the 
metatarsal bones; but (a point especially to remember, 
because of its great importance in scientific treatment of 
the foot) chiefly on the metatarsal of the great toe, and 
on the OS calcis or heelbone behind. The astralagus is 
the keystone of the arch. (See Figure 24.) 



Anatomy of the Foot ii, 




Fig. 24 

THE ARCH OF THE FOOT 

a^Metatarsal b=:Os Calcis a=Astralagiis 

Ligaments, or strong bands, hold this marvellous piece 
of mechanism together and thus make it capable of up- 
holding the weight of the body, yielding only a little as 
one moves, without giving way. 

If we stand on one foot, the arch flattens and length- 
ens. If we rest the foot or dangle it over a chair, the 
curvature increases. 

To have one leg on the floor and the other crossed over 
its knee gives each foot temporarily a different arch. 
And so in walking, as the foot is raised, by the action of 
the muscles, the curvature is immediately increased. 

This arch is practically developed to its proper adult 
form about the sixth year of life; being more or less 
flattened during infancy and early childhood. Connect- 
ing it with the metatarsus, the great toe has but one joint, 
while each of the smaller toes has two. 

From what has been said of the architectural relation 
of the great toe and the heelbone to the arch as a whole, 
it will be seen that in walking the chief work of the foot, 
running along a straight line from heel to great toe, falls 
upon the latter. 

The great toe ought, therefore, as Professor Herman 
Meyer of the University of Zurich demonstrated over 



12 



The Care of the Foot 



fifty years ago, so to lie, when on the ground, that the 
Hne of the axis, a line drawn straight through it, back- 
ward, would come out at the very centre of the heel. 
This is the position of a great toe on a perfectly sound 
foot as exemplified in the illustration Figure 25. 




Fig. 25 
THE AXIS OF THE FOOT 

While insisting on the importance of the great toe, 
and the special care it should receive, the writer does not 
mean to minify the value of the smaller toes, or detract 
from the attention that should be paid to them likewise. 
They have their uses. 

One of these is the giving of side support to the foot, 
when standing. Another is in walking, to bend in such 
a way as to press firmly against the ground; in this, 
too, giving a side support to the foot. The peculiarity 
about the walking curvature is, that the first joint bends 
upward strongly, while the second is hollow above. This 
would give to the smaller toes, if one went barefoot, a 
little grip on the ground such as is taken by the claws 
of a bird when walking or hopping about. 

In order to ascertain the exact character of the arch 
effect, the chiropodist should have the patron place the 
bare foot firmly, but naturally, without undue pressure, 
on a sheet of paper that has been previously blackened 



Anatomy of the Foot 13 



with the smoke of burning gum of camphor. The im- 
print thus made will give a fairly indicative outline as 
to the perfection of the arch or its deviation from per- 
fection. 

A broken-down arch, if complete, gives an outline of 
the entire sole of the foot, showing the more or less 
elliptical imprint of the ball of the foot; the dividing 
line between the round impression of the heads of the 
smaller toes and the pear-shaped impression of the great 
toe ; the rounded area of the heel, and a line at the outer 
border of the foot, more or less pronounced, which con- 




Fig. 26 
THE FOOT PRINT 

nects the imprints of the heel and the ball. A good 
idea of this impression may be obtained from Figure 26. 

The practitioner, when he has taken several hundred 
of such arch impressions, will very likely have become 
such an expert that he will hardly need to take them; 
the eye will tell him, sometimes at a glance, just what 
the matter is with the patron's arch, and what should 
be done to correct it. 

In outline the foot from its inner side should appear 
practically as shown in Figure 27. 



14 



The Care of the Foot 




Fig. 27 
THE NATURAL ARCH 

If the arch has become flattened, the bones of the foot 
spread apart and sink down, so that the entire sole of 
the foot either touches or almost rests upon the floor. 
Such a foot is shown in Figure 28. 




Fig. 28 
THE FLATTENED ARCH 

This sinking of the arch varies, of course, with eacH 
individual. If after walking for a while, one has a con- 
tinual dull ache in the foot, particularly the outer side 
of it, and a corresponding stitch in the calf of the leg, 
this is a warning that the ligaments of the arch are loos- 
ening, and that the arch is likely to fall. Specific cause 
and treatment will be given later. 



CHAPTER II. 
SHOES. 

Ancient Shoes: the Sandal, the Buskin — The Mocca- 
sin — The Chinese Shoe — The Chiropodist as a Shoe Ex- 
pert — Meyer's Reformation in Shoe Construction — Char- 
acteristics of a Proper Shoe — Children's Shoes. 

Far more than any other part of the body the foot is 
affected by its covering. Every chiropodist should be 
an expert on shoes, knowing the subject from begin- 
ning to end. The footgear of the ancients shoves a much 
clearer understanding of the rights of the foot as a mem- 
ber of the body than we somewhat self-appreciative 
moderns appear to possess from the kind of foot cov- 
erings we generally wear — to our constant discomfort 
and often to the serious impairment of our health. 

It might almost be said that one good reason why 
Egypt flourished, and Rome stood so long, was because 
their inhabitants kept their feet so well; so uncramped; 
so able to support the rest of the frame in comfort, with 
ease and with power. 

Study the illustration (Figure 29) of an Egyptian 
woman's foot, and note how the simple, light sandal af- 
fords ample protection to it against injury below and 
yet allows it free play above. Would anything in foot- 
wear have been more fit in a climate mostly warm and 
dry, like that of Egypt? 

Mark the finely arched instep and the straightness of 
the toes. Such feet were almost as beautiful as hands, 

15 



i6 



The Care of the Foot 



and merited all the care they received. They never had 
corns, and only by accident callosities. 




Fig. 29 
THE ANCIENT SANDAL 

Illustration 30 gives a fairly good representation of the 
old Roman foot covering called the cothurnus, or buskin. 
This was laced not overtightly (for that might interfere 
with circulation) over only the root of the toes, permit- 
ting even more free play than did the sandals of those 
pedal digits. 




Fig. 30 
THE ROMAN BUSKIN 

The Roman buskin had a sandal sole made to fit the 
foot, instead of the foot being forced to fit the sole. 
Compare, too, the evenness in length of those noble 
Roman toes, and their straightness, v^ith the irregularity 
of the modern foot with its one bulgy lop-sided big toe 
and four curlycue runts beside it. 



Shoes 17 

On the ordinary Roman sandals, the thongs or strips 
of a thinner, more pliant leather, separated the toes and 
strapped the sandal to the foot, to keep the toes from 
leaning on or overlapping each other. Feet, thus dressed, 
gave off their perspiration naturally, and did not hive 
it up to become offensive in odor and productive of soft- 
ness of the skin and of ultimate disease. 

It is pleasant to note that we are beginning nov^, in the 
raising of our children, to realize the value of sandals; 
and it is to be hoped that this fashion, which allows the 
feet to grow naturally and spread properly, will continue 
to spread until it reaches to adults. 

For men and women who spend the summer in country 
places or at the seaside the wearing of sandals in summer 
and as late into the fall as comfortable would be ex- 
tremely beneficial. All athletes, whether practicing in 
the gymnasium or engaged in exhibitions or playing any 
game, except football, would be immeasurably benefited 
by a return of the sandal of the ancients. To golfers 
particularly, with the undulant character of most golf- 
links, the sandal would be a boon. 

The American Indian covered his feet entirely with 
soft leathern mittens called moccasins. It would be 
well if these replaced the modern "sneakers" whose soles, 
being made of rubber impervious to perspiration, render 
them pernicious to the health of the feet. Pliable leather 
is the best protective foot covering in a cold climate. 
The Esquimos make their boots of skins, lining them 
with fur and eiderdown, and for these Arctic explorers 
invariably cast aside the stiff boots of civilization. 

Wood, instead of hard leather, is used to protect the 
soles in many countries. 

From time immemorial the Chinese have worn shoes 
having wooden soles lined with soft material and cloth 



The Care of the Foot 



uppers in slipper fashion, which give the feet consider- 
able freedom of movement, and consequent immunity 
from corns. (See Fig. 31.) 




Fig. 31 
THE CHINESE SHOE 

But even in wise old China, Fashion, that teeming 
mother of many deformities as well as absurdities, has 
decreed that certain feet should be compressed to as 
great an extent as possible, limiting, however, this 
cruel and hideous folly to the girls of the aristocracy, 
who were regarded as toys, rather than creatures with 
souls demanding activity in service, and whose helpless- 
ness, therefore, was an ostentatious proof of the hus- 
band's ability to afford such a luxury. 

The method of doing this, which is undertaken almost 
from birth, entails constant pain throughout girlhood. 
By the tight bandaging, the bones are displaced upward 
so as to render it short along the line of the sole and 
apparently small, though the actual size of the foot, thus 
distorted, remains about the same. 

Carried to extreme extent, this practice renders the 
Chinese belle a cripple, able only to hobble ungrace- 
fully, and sometimes, when fatness arrives, necessitating 
her being lifted around by servants, a pitiable piece of 
feminine furniture, to whose helplessness the European 
or American woman but feebly approaches with her 
"French heels" and "hobble skirt." 



Shoes 19 

There is no evidence in their literature that the ancients 
experienced such afflictions as bunions or corns. 

It was with the advent of the modern shoe that all 
forms of foot distortion and foot-disease appeared, and 
with its spread that these multiplied until a perfectly 
shaped and perfectly healthy foot is a greater rarity than 
anything to be found in an anatomical museum. 

Even shoes of our grandfathers' days, being custom 
made, were not so likely to cause abnormalities of the 
feet, but the recent shoes, manufactured in fixed styles 
and built on lasts peculiar to each manufacturer, have 
cut a terribly wide swath of havoc, making the chiropodist 
or foot-doctor an increasing necessity in our scheme of 
civilization. 

When this highly important specialist first made his 
appearance, not so very many years ago, he was looked 
at askance as a cheap faker who gave only temporary 
relief. Unfortunately, this was not only true in most 
cases, but still worse, his treatment often caused irrep- 
arable damage. 

And to-day, there are still many deplorably ignorant 
persons presumptuously calling themselves pedicures, and 
practising chiropody under license from the various 
States. As Dr. Kahler, who had the honor of attending 
to the sore feet of Abraham Lincoln, with just indigna- 
tion remarks, these quacks, "ignorant of anatomy and in- 
capable of performing a delicate operation, possessing 
only a few salves and the knowledge of some powerful 
acids or astringents, and often doing more harm than 
good, have brought the profession of chiropody into con- 
tempt, and to them are applied such names as corn-doctor, 
etc." 

Accordingly, every earnest and honest would-be chirop- 
odist should first understand the Anatomy of the Foot, 



20 The Care of the Foot 

and, second, should study the make of shoes and be able 
to instruct patrons just what kind of shoe to wear; other- 
wise, only temporary relief, not cure, is the result, and 
the foot-doctor, instead of being a desirable citizen and 
an honor to any community, is a cheap charlatan whose 
practice is to keep persons continually coming to himself 
or to somebody else, as patients, instead of curing them 
and thus converting them into active advertisers of his 
probity and skill. 

There are, however, reliable and conscientious chirop- 
odists, and when one is found it is a good plan to visit 
him at least once in every six months and have the feet 
examined, just as it is a good plan to have one's teeth 
examined that often by a reliable dentist. 

If one has very fine or tender feet a visit every three 
months, instead of semi-annually, would be advisable. 
Even for persons possessing comparatively healthy feet, 
to have them pedicured as often as they have their hands 
manicured would be well worth the expenditure of time 
and money. 

The Right Kind of Shoe. — It stands to reason that 
no two pairs of feet are exactly alike. Therefore, the 
shoes of modernity, manufactured by wholesale accord- 
ing to set forms, would inevitably cause mischief to 
some feet, even if the said shoes were built along the 
general natural lines dictated by the foot's architecture. 

So, inasmuch as comparatively few can afford to have 
shoes made especially to fit their feet perfectly, there is 
all the more reason why shoe-manufacturers should 
endeavor to seek such guidance from a study of anat- 
omy as would enable them to build shoes which would 
average a fair conformity with nature's clear intention, 
and so create the least amount of mischief possible. 



Shoes 21 

But, as pointed out more than fifty years ago by Dr. 
Hermann Meyer, the pioneer in the arduous field of re- 
forming shoe-manufacturing methods, this is not done, 
as it ought to be, either universally or even locally to 
any extensive degree. Ignorance, intensified by fashion, 
has dominated, and in consequence the feet, the founda- 
tion of our physical superstructure, have suffered and 
will continue to suffer. 

In the illustration (Fig. ^2) of a perfectly normal 
child's foot, it will be noticed that a straight line drawn 
through the middle of the big toe emerges at the centre 
of the heel, iand the same will be noticed in the illustration 
(Fig. 25), which is that of a healthy natural adult mas- 
culine foot. But in the feet of most adults, owing to 
the shoes they have been wearing, there is a marked 
deviation, the great toe having either sprawled outward 
or crawled inward onto other toes. 



Fig. 32 
NORMAL FOOT OF A CHILD 

The chiropodist, therefore, after making a drawing of 
the patron's naked foot on paper, running the pencil 
lightly into the indentations indicated by the toes, should 
find whether the medial line of the great toe corre- 
sponds with that of the outer surface of the heel. (See 

Fig. 33-) 

There is then before him the problem of coaxing the 
great toe into line again, if it has taken an abnormal 
position or has abnormally grown outward. 



22 



The Care of the Foot 



Where the curvature is inward, plugs of cork, prefer- 
ably wrapped round with soft cloth, are to be inserted; 




abi 



Fig. 33 
THE MEDIAL LINE 
rimproper medial line cd=proper medial line 



the size of the plug should be increased gradually, say, 
week by week, and the kind of shoe to be worn must be 
not only roomy at the toes, but should be considerably 
longer than the toes. 

If, on the other hand, the toe has sprawled outward, 
a soft cotton bandage, holding it pretty tightly, should 
be worn and the shoe should be narrower across the 
toes (see Fig. 34), but, as before, a little longer, so that 
the toe may have opportunity to straighten forward. The 




Fig. 34 
SHOE TO CORRECT SPRAWLING GREAT TOE 

stocking in this latter case should clasp the forepart of 
the foot somewhat more snugly than usual. 

This slight elongation of the shoe beyond the toes not 
only affords fair play to them, and helps their general 



Shoes 23 

health, but it adds grace to the looks of the feet, espe- 
cially if they be naturally broad. A short, thick foot, as 
has been said before, can be made to look more graceful 
by the selection of a shoe somewhat longer than is needed 
for an exact fit. 

Dr. Meyer did not succeed in getting the manufac- 
turers of his time in Europe to adopt his ideas to any 
noticeable extent, but his treatise, translated by John 
Stirling Craig and published by R. T. Trail & Co. in 1863, 
stimulated study of the foot in this country and led some 
makers of shoes to try his methods. They appear to 
have been discouraged, because not enough persons 
among the general public had sufficient understanding 
to appreciate the reform and by their patronage make it 
pay. 

Some of Meyer^s ideas, however, had taken partial 
hold of the public, particularly his approval of the so- 
called congress shoe, in the matter of substituting elastic 
at the sides for lacing. But the popularity this kind 




Fig. 35 
SHOES IN THE MEYER STYLE 

of shoe once had was very likely due to the ease with 
which it could be put on and drawn off, rather than to 
the higher hygienic quality. 



24 The Care of the Foot 

Recently, however, there has been considerable attempt 
to restore the general shape of shoes approved by Dr. 
Meyer, a shoe that is comfortably broad and that ap- 
pears to turn inward (see Fig. 35), but the value of 
this has been nullified in great measure by making it 
too narrow at the side next the smaller toes. We are 
speaking now of men's shoes. Reform in the footgear of 
w^omen is a more stupendous task. 

Objection may be offered that the wearing of these 
shoes of uncurved shape might eventually lead men to 
turn in more in walking or become "pigeon toed" as it 
is called, in their locomotion. This, of course, could be 
guarded against by the wearer making during the first 
three weeks of wear a conscious effort to toe out a little 
more than he usually would. 

On the other hand, a slight broadening of the leather 
under the arch of the foot would take away the look of 
extraordinary incurvation and would perhaps add not a 
little to ease and grace in movement, and a slight exten- 
sion of the toe part, as indicated in Fig. 34, would also 
add to its appearance. Where the instep is at once high 
and thick, such broadening would, of course, naturally 
suggest itself as fundamentally proper in the making of 
a shoe. 

In advising a patron as to the kind of shoe to buy, the 
things to dwell upon with polite insistence are: 

1. Sufficient width of sole. 

2. Sufficient room for toes. 

3. Sufficient lowness of heel, 

4. Sufficient elasticity over instep. 

And in case of soreness or crookedness of toes, as 
intimated previously, extra length in the toe part should 
be advised, until the condition has been permanently 
I rectified. This does not exceed in any direction; it does 



Shoes 25 

not mean a shoe in which the foot sHps about as in a 
slipper, except that in the point of length the shoe may 
extend considerably, which, while doing good to the 
toes, also adds to the shapeliness of a shoe's appearance. 

The shoe should fit rather snugly to the foot. The 
foot should not be cramped, but firmly grasped by its 
leathern envelope. If the shoe is too large, the foot 
slides to and fro in it, which not only causes discomfort 
and tired feet, but induces corns and callosities, and even 
inflammations that require weeks to overcome. 

It is equally true that a tight shoe, so generally worn, 
especially by women, is quite as harmful, if not more 
so, as a shoe that is too large for the foot. Tight shoes 
cause not only foot-ache, but lead to all kinds of troubles, 
such as corns and bunions, and also induce diseases of 
the blood vessels of the lower limbs, pain in the calves 
of the legs, headache and, in some extreme cases, trouble 
of the eyes. 

Normal shoes, as before stated, should fit snugly, but 
should allow plenty of room for the toes. They should 
also give support to the arch of the foot by having a 
heel of medium height. High heels are injurious to 
the health of any wearer and a torture to many. 

The weight of the body should be so distributed to 
the ball and heel of the foot that standing should be 
comfortable and walking a matter of easy grace, even 
under unusual strain, if such be not repeated too fre- 
quentl}^ 

The toe of the shoe should never be anything but 
of the shape of that part of the foot, slightly narrower 
than the bare or stockinged foot in standing. The shape 
of the shoe should conform to this and not be boxed or 
raised so that the cramped toes overlie one another. 

A common-sense shoe can be made as beautiful as any 



26 The Care of the Foot 

other, and its comfort will conduce to health and pros- 
perity, for it may be truly said that one who has chronic 
trouble with his feet is heavily handicapped in the race 
of life. 

A short, thick foot can be made to look more graceful 
by the selection of a shoe somewhat longer than is needed 
for an exact fit. 

Remember that only in extreme cases of deformity 
shoes need be fashioned to fit that deformity. In aver- 
age cases the foot after treatment should be confined 
in a shoe made according to the natural method, but 
a shade larger than if the deformity were not present. 

For displaced joints and bunions a shoe considerably 
larger than the foot should for obvious reasons be worn 
at first; but, as the displacement disappears or the bun- 
ions give signs of cure, the size of the shoe should be 
correspondingly lessened. There are cases where, on the 
road to recovery, the patron may properly be advised to 
change the shoes several times in this way. 

The ideals to be sought in a shoe are three: 

1. Comfort. 

2. Beauty. 

3. Durability. 

Here every chiropodist is going to meet his chief ob- 
stacle, particularly in dealing with feminine patrons, and 
frequently with men. 

Style, a word derived from the sharp-pointed instru- 
ments used by the Greeks and Romans as a pen, and 
from which the Italian word, stiletto, the weapon of 
assassins, is in turn derived, has indeed been for years 
a weapon wounding thousands and thousands of people. 

All womxcn really wish for beauty, but the obsession 
of the majority seems to be that one cannot have beauty 
unless one is in style. 



Shoes 27 

The truth is that any style, however fascinating, which 
in any way deforms the natural shape of any member 
of the body and thereby interferes with free play of 
functions, is contrary to the Law of Beauty, and should 
be religiously shunned by women for their own sake, 
and the sake of their children, or the children they 
may have if their womanhood arrives at full bloom and 
fruitage. 

The wisest book in the world declares that the body 
is the temple of the living God. Now, the foundations 
of that temple are the feet. If these foundations are 
impaired, the whole temple may totter, and the light 
within the dome, the mind, be extinguished. 

It was proved by the world-famed surgeon, Brown- 
Sequard, that the weight of the body, improperly thrown 
on one man's great toe, unbalanced his mind to a violent 
degree. To effect a cure a bisecting of the nerve was 
necessary. 

The mysterious connection between the nerves of the 
feet, practically those of the great toe, and the brain, is 
now known, though not yet fully understood. But it 
might be hinted that one cause of many persons going 
astray mentally — and morally — lies in the ill-treatment of 
the feet from childhood up. 

Mothers ought not to let their children begin to walk 
as early as they do; ought never to cramp the growing 
feet or stuff them into ^'stylish" shoes; ought to take 
their children early to a first-rate chiropodist and faith- 
fully follow his advice. 

In childhood the bones of the foot are soft and pliable. 
Machine-made shoes, bought for sake of economy, are 
an outrage on the helpless little one, and also entail extra 
expense in many ways as life goes on. 

Every child is entitled to have a shoe in which the 



28 The Care of the Foot 

foot can grow naturally. Anything else is an abomina- 
tion. 

If this reform can be started and maintained, in one 
generation crooked toes, corns, inverted nails, swollen 
joints, and bunions will virtually have disappeared. 

If your patron is a wife and a mother, talk to her earn- 
estly about baby's feet. Every mother whose feet have 
been a torture to her in any way will appreciate this, 
and, even though she may wilfully continue to suffer her- 
self, and for the sake of wearing ^'stylish" shoes refuse 
to be cured permanently by you, she will nevertheless in 
ninety-nine cases out of a hundred have loving sense 
enough to desire that her children be set right as to 
their feet and started well, to that extent, in the race of 
life. 



CHAPTER III. 
THE CARE OF THE FEET. 

Change of Shoes and Stockings — Bathing — Nail-Trim- 
ming — Advice for Patrons. 

Shoes should be changed every day to save both feet 
and shoes, tvi^o pairs of shoes as near alike as possible 
being ordinarily sufficient. This alternation helps each 
pair to hold its shape, as well as to last much longer. 

Alternation of socks or stockings from day to day, 
like alternation of shoes, is a good plan. The stockings, 
when removed, should be turned inside out and hung up 
to get well aired. They may be worn three times with- 
out washing. If they are not thus changed, clean ones 
should be put on at least three times a week. If it is 
convenient, or one's purse permits, a change at the end 
of the day for evening wear is advisable. 

Frequently it rests the feet to rub them with a soft 
towel, or special footcloth, expose them to the air for 
a few minutes, and then don the evening socks. In all 
this we are speaking of comparatively normal feet. 

When one has particularly sweaty feet, special reme- 
dies for which condition will be given later, a much 
more frequent change of stockings naturally suggests 
itself. But one should not, without the sanction of his 
chiropodist, switch from one kind or one thickness of 
the same kind to another. 

Stockings. — Stockings of which the toe section is 
white or cream white are preferable. The tops may be 
29 



30 The Care of the Foot 

of any fast color the fancy chooses. The dyes of col- 
ored stockings irritate the skin and often cause ulcers or 
soft corns by setting up inflammation between the toes. 

Stockings should not be loose. When they grow so 
by frequent use and washings, they should be discarded. 
Loose stockings on tender feet by bunching in places 
cause irritation, and may produce inflammation if per- 
sisted in. Even if the creases do not seem at first to 
threaten any evil results, they cultivate the ground for 
corns and callosities. Stockings ought to fit snugly like 
a glove, but to possess elasticity enough not to interfere 
with the foot's expansion in motion. 

Stockings are sometimes made with a special compart- 
ment for the ''big toe" — the toe of honor, on which the 
burden of walking is thrown. In some cases, the use 
of such is to be particularly advised, and, if it could be 
made practicable, doubtless the whole stocking might 
be well converted into a foot-glove, with separate 
places for each pedal digit. 

Heavily darned socks are just as deleterious as those 
with holes at the toes. Both kinds discomfort and irri- 
tate the wearer unless the feet are unusually tough. 

It is desirable to have rights and lefts in stockings, 
though it is hard to persuade patrons to do so. 

If the feet are tired and swell at night from too much 
standing, they should be bathed in hot water to which 
several tablespoonfuls of sea salt or even common salt 
have been added, and then be well dried and bound 
with white flannel bandages. 

If the feet are cold, the bath should be followed with 
bandages of red flannel, or they should be rubbed with 
cologne spirits, witch hazel, or rum. 

Upon arriving at home after the day's toil, it is well 
to rest the feet by putting on slippers with lower heels 



The Care of the Feet 31 

than in the shoes worn during the day. "Slippered 
ease" is as hygienic as it is sybaritic. 

For persons who have* sedentary occupation, a foot- 
rest, or cushion several inches above the floor, is ad- 
visable. This is particularly so when the floor is of 
stone, or cement or tiling, as in many business places, 
or when it is of wood, but has been exposed to cold 
or damp air. Many carpets retain dampness. Any floor 
covering that cannot be often taken up and thoroughly 
cleaned is dangerous to health. 

A fine foot bath for tired feet is made by adding the 
following to the simple hot foot bath : 

FOOT BATH 

IJ Alum ]/i 02, 

Borax i " 

Sea Salt i " 

Tender feet may be rubbed to advantage with witch- 
hazel, to which spirits of camphor have been added, one 
or two teaspoonfuls to four ounces of the former. Also 
to rub a little pure olive oil into tender feet, as well as 
upon dry and cold feet, at night after the bath is bene- 
ficial. 

Nail Trimming. — The nails of the toes should be 
trimmed at least once every two weeks. All calloused 
skins should be very gently scraped oif or ground down 
with a pumice stone after the bath. 

The nails should be cleaned of dirt and accumula- 
tions, taking care not to injure the cuticle under the 
nail, since such injury will cause them to ingrow just as 
cutting them too short will. 

The nails should be cut squarely and not rounded as 
are the finger nails. The nail of the large toe should 
be cut concave, that is, closer to the toe in the centre 
than at the sides. 



32 The Care of the Foot 

Dead cuticle or scales of scarfskin or epidermis should 
be scraped away with a blunt orangewood stick or cuticle 
knife, taking care not to injure the skin or make it bleed, 
since this invites poisoning either from stocking dye, 
if one is foolishly wearing dyed socks, or from the dirt 
which accumulates in the shoes combining with decom- 
posing sweat. 

All wounds made in pedicuring should be cleansed 
with an antiseptic solution at once and be covered with 
antiseptic absorbent cotton. 

ANTISEPTIC SOLUTION 

B Carbolic Acid (pure) i dr. 

Glycerine 4 dr. 

Mix and apply with cotton to wound. The above so- 
lution may be used on such wounds, or a solution of 
boric acid, 10 grains to each ounce of water, may be 
substituted. 

Specific treatment of diseases of the foot will be de- 
scribed later. 

If the feet are naturally weak and cold more or less 
of the time, much can be done to bring them into a 
healthy state by bathing them every night in a hot water 
and sea-salt mixture made as already described. While 
the feet are in the bath, they should be scrubbed vigor- 
ously with a fairly stiff nail- or hand-brush to arouse 
the circulation, and by the pressure of this increase of 
blood to the parts to invite better nourishment to the 
skin, which before long will become thicker and more 
able to resist sudden changes of temperature. 

Cold feet are often the result of overactive brain 
work. If this is the cause, the life of the patron should 
be regulated, and outdoor exercise and calisthenics in- 
sisted upon. If the cause of this uncomfortable con- 
dition is due to any other physical disturbance, the pa- 



The Care of the Feet 33 

tient should be sent at once to a physician for proper 
medicinal care. 

Advice for Patrons. — ^You may truthfully tell your 
patrons in an incidental way the following facts : 

Sore feet hasten the advent of old age. 

Diseased feet cause premature grayness. 

Every long-neglected corn may be the seed of a dozen 
gray hairs. 

Shoes too small, or improperly made, cause injury to 
the feet, sometimes permanent. 

The story of injured feet writes itself in wrinkles on 
the face. 

High heels cause wealc knees. 

Weak knees pave the way to nervous breakdown. 

Wearing of improper shoes indisposes one to take 
proper exercise. 

Lack of proper exercise invites either adiposity or 
consumption. 

Pressure of pain in any part of the body, long con- 
tinued, seriously mars the expression of the face, dis- 
turbs and sometimes ruins the disposition, and may 
upset the brain at last. 



CHAPTER IV. 
CHIROPODY. 

The Necessary Instruments — Preparation of the Feet 
— Treatment of Hard Corns : By Knife Alone ; Medici- 
nal Method — Inflamed Hard Corns — Soft Corns — Vas- 
cular Corns — Removal of Callosities — Treatment of In- 
growing Nails — Of Bunions — Recipes — Treatment of 
Flatfoot — Artificial Arches — Treatment of Chilblains — 
Recipes — Treatment of Perspiring Feet — Recipes- 
Treatment of Hot Feet and Cracks Between Toes. 

The instruments necessary for the chiropodist are 
not many, but these few should be of the best kind. 
Cheap steel instruments soon lose their cutting edges 
and have to be thrown away. The repeated buying of 
such makes the ultimate expense far more than when 
the best are bought in the beginning. 

Following is a list of what are required: 

1. Nail Clipper. 4. Scalpel. 

2. Nail Scissors. 5. Pair Tweezers. 

3. Corn Knife. 6. Hone. 

7. Pumice Stone. 

Nail Clipper. — The nail clippers should be of the 
best steel, with the nail-cutting or clipper curved so that 
v/hen clipping off the nail it will give the required shape. 
It is illustrated in Fig. 36. 

The blades should meet evenly and be sharp so that, 
by bringing the handles together, the nail will be evenly 
and quickly clipped off. 

34 



Chiropody 



35 




Fig. 36 
NAIL CLIPPER 

Nail Scissors. — The scissors should be curved on the 
flat. The blades should be stout and short. This instru- 
ment is used to cut or trim the nails as well as pieces 
of loosened skin of soft or hard corns; therefore it 
should be of the best quality of steel. The proper kind 
is shown in Fig. 37. 




Fig. 3^ 
NAIL SCISSORS 

For hygienic reasons the so-called French lock is to be 
preferred, since this allows them to be taken apart and 
thoroughly cleansed and dried. The ordinary screw lock 
is hard to clean and invites sepsis. 

Corn Knife. — This instrument is a type of razor, a 
short, slightly hollowed blade with one cutting edge, 
blunt at the end and back, where it is thickened. 

The handle should be of steel, nickel-plated to insure 



36 



The Care of the Foot 



cleanliness. Bone or horn handles soon become loose 
and useless from the boiling which is necessary in the 
proper cleaning of all instruments, and antiseptic solu- 
tions attack them readily. The proper instrument is 
shown in Fig. 38. 




Fig. 38 
CORN KNIFE 

This instrument should never be used on the nails or 
bony callouses, for such employment soon destroys its 
fine, razor-like edge. 

Scalpel. — This is really a small, metal-handled oper- 
ating knife which is used for paring off callous skin and 
soft corns, and not for cutting hard corns. It should be 
of the best steel, not too thick in the blade and of the 
size and shape shown in Fig. 39. 



Fig. 39 
OPERATING SCALPEL 

Tweezers. — The tweezers should be of steel, with 
stout, well-meeting sharp points, ribbed inside of the 
points and outside in the handles to permit of a firm hold. 
They are used to raise pieces of skin or soft corns that 
have been loosened, or partially dissected with the scalpel, 
and which are to be cut away finally with the scissors. 
These tweezers are called Dressing Forceps, and are 
shown in Fig. 40. 

The tweezers are also to be used to convey dressings 



Chiropody 37 



of small size to the parts operated on, or to crowd cot- 
ton under ingrown nails, as later described. 



II iiiiiia\^i| \ y\ ^ ~ 



Fig. 40 
DRESSING FORCEPS 



Hone. — The hone to be selected for the sharpening of 
knives should be of the best quality. The usual barber's 
hone is a little too fine. An oil stone of high quality an- 
swers best. It should be about four inches long, and one 
and one-half inches wide. Plenty of oil should be used 
in sharpening, and the knife should be drawn evenly to- 
ward the centre of the hone, edge inward, first the one 
side and then the other of the knife. A number of 
strokes are needed to get a good edge. Drawing the knife 
away from the centre of the hone with the knife edge 
outward tends to give a sawlike edge. 

Pumice Stone. — At the present day pumice stone may 
be had in various-sized pieces of regular shape, either 
oblong, oval or round. It is best to purchase one of 
these, instead of using the rough and irregular stone, 
as it makes a better impression, while it does the work 
more effectively. 

Preparation of the Feet. — To prepare the feet prop- 
erly for pedicuring, they should be soaked for a few 
minutes in as hot water as can comfortably be borne. A 
little borax, about a teaspoonful, may be added to the 
water. It renders the latter slightly antiseptic, and helps 
to soften the cuticle and corns as well as the toe-nails. 

Remove the feet from the bath and dry with a clean 
towel, rubbing downward toward the toes. Dry well and 
pay particular attention to the skin between the toes. 



38 The Care of the Foot 

Moisture does not permit of good work. When the skin 
is wet the fingers are liable to slip nor can the instru- 
ments render as good service. 

Diseases of the Feet. — There are a number of dis- 
eases of the feet which the chiropodist will be called upon 
to treat and overcome ; and to give the proper knowledge 
and the practical method of treatment each will be fully 
considered under its own heading. 

Corns. — The most common disease of the foot is the 
so-called corn. There are three types generally con- 
sidered : 

1. Hard Corns. 

2. Soft Corns. 

3. Vascular Corns. 

Hard Corns. — These painful, localized callosities are 
usually found upon the toes, particularly on the second 
joint of the small toe, but they may occur on all toes, 
and at one or both joints of each, or the skin over one 
or two of such joints of all the toes may alone be af- 
fected. 

A corn is composed of callous skin, having a central 
plug of homy skin pointing downward into the sensi- 
tive layer of the true skin. The outer cuticle, or horny 
layer of the skin, is thickened by reason of constant 
irritation, or the pressure caused by shoes which are 
either too tight or too loose, or which do not match the 
shape of the foot. In tight shoes, the cause is pressure; 
in loose, friction; in shoes that do not perfectly fit the 
shape of the foot, it may be both. 

As the horny layer becomes thicker, the plug be- 
neath its central point is forced deeper into the sensitive 
true skin, and walking becomes a painful task, even the 
mere touch of the finger sometimes producing an acute 
ache. If the cause of the disease continues, the skin 



Chiropody 39 



about and below the corn becomes highly inflamed, and 
an abscess may eventually form which at once becomes 
a serious condition, liable, without proper antiseptic 
care, to end in blood poisoning. 

When, therefore, one discovers a com on one of the 
toes, it should be treated at once, not simply to cut away 
the callous skin, but to remove the corn permanently. 
This will sometimes prove a tedious task, especially if the 
patron persists in clinging to the ascertained cause of 
the trouble. 

It is well to tell your patron that to cut away a corn 
and give present relief is an easy matter, whereas to 
prevent its recurrence requires not only skill on your 
part, but the patron's co-operation. Much can be done, 
however, in the average case by following the methods 
herein given. 

The foot upon which the corn has come is immersed 
in a hot footbath. The water should be as hot as can be 
well endured, since the heat by expansion of tissue softens 
the corns, at the same time reducing the irritation of the 
whole toe. The foot should remain at least ten minutes 
in the bath. It is then dried, and placed with the heel 
down upon a properly cushioned stool, which has pre- 
viously been covered with a clean towel. 

The afflicted toe is then taken between the thumb and 
forefinger of the left hand. The corn knife is held in 
the right, and with it the operator, gently and carefully, 
pares down the hard mass, working from the centre of 
the corn outward or toward himself. 

Proceed in a circular manner to trim away all the 
callous part, until the skin becomes thin and rosy in 
color. Do not cut so deeply as to draw blood. 

This done, apply a little carbolated vaseline to the part 
operated on and allow it to be absorbed. 



40 The Care of the Foot 

The next step is to prevent further friction or pres- 
sure. To overcome this, cut out a disc of felt, or one 
or two pieces of chamois skin, about four times the 
size of the corn. Then cut a circular piece out of the 
centre of the disc of the material used, about twice the 
diameter of the corn. 

The disc, thus formed, is laid upon the toe with the 
corn at the open centre. Fasten the disc down with 
several fine strips of adhesive zinc oxide plaster, or 
paint the part over with flexible collodion, applied in 
several layers with a fine camel-hair brush, letting it 
dry and harden. 

Flexible collodion can be obtained at any drug store. 
It forms a skin or film when painted on any surface, and 
is preferable to plasters, which are liable to be sweated 
off or rubbed off in walking. 

The stocking may now be drawn over the foot and a 
proper shoe worn. An old shoe will be found best for 
the purpose, or the shoe may be cut in such a manner 
that the pressure over the corn is relieved. If the pad 
is properly put on, in nine cases out of ten cutting the 
shoe should not be necessary. 

The pad, or disc, applied as directed, is removed the 
second or third day, and a new one applied. This treat- 
ment should be continued until the corn disappears, or 
until it fails to rebuild itself. After that the patron 
should look to the wearing of proper shoes. 

The Medicinal Method. — Another method of re- 
moving a corn permanently is to pare down the hard cal- 
lous mass and then paint the corn with the following 
mixture : 

IJ Salicylic Acid ^ I gram 

Tincture of Cannabis Indica Yz gram 

Alcohol 95% I gram 

Ether 63% ^^ grams 

Flexible Collodion 5 grams 



Chiropody 41 

A coating of this paint should be applied on the corn 
every day for at least a week, care being used not to 
paint the surrounding skin. On the eighth day, after 
a hot footbath, remove the collodion skin and the corn 
will come away with it. If it does not come away en- 
tirely, the same method is to be repeated. 

Once removed, all pressure of the shoes at the af- 
flicted part must be guarded against. 

Another method is to use the following plaster : 

^ Resin s dr. 

Balsam of Tar ^Yz dr. 

Salicylic Acid 5 dr. 

Melt the resin and balsam together over a slow fire; 
add the acid and stir until the mixture is even. 

Then place a pad of felt, or chamois skin, with a hole 
in its centre over the corn. This pad should be stuck 
to the skin, with a mixture of equal parts of balsam 
of fir and resin, melted over a slow fire. Stir well, and 
while still warm, paint it on the under side of the 
felt or chamois skin, which, when cold, can be cut into 
discs, and a hole made in the centre. 

Having fastened the disc to the corn, a little of the 
paste, of which the recipe has just been given, is put 
into the hole over the exposed corn. A quantity equal 
to the size of a half pea is about sufficient. This is al- 
lowed to remain in the corn for one or two nights, or 
until it drops off of its own accord, when the corn will 
come away with it. If the corn is not entirely removed, 
the method is repeated. All pressure of the shoe should 
be guarded against thereafter. 

Inflamed Hard Corns. — If the skin about a hard 
corn is inflamed and tender, it is best to reduce the in- 
flammation with hot water baths, allowing the foot to 



42 The Care of the Foot 

remain in the bath at least fifteen minues. Dry the skin 
thoroughly and relieve the com of all shoe pressure with 
a chamois pad as above directed. Repeat the bath the 
next day and remove the corn as heretofore directed. 

If the above treatment does not overcome the sore- 
ness, place a hot poultice of linseed meal about the corn 
overnight, removing the corn the next morning. The 
linseed meal is mixed with hot water till it forms a paste, 
then is put in cheese cloth as applied, or may be plas- 
tered over and bandaged on, the meal coming into direct 
contact with the corn and surrounding tissue. 

Soft Corns. — The soft corn is, in structure, the same 
as the hard com; but is found usually on the side of 
the toe where there is sufficient moisture to keep the 
callous skin soft. 

To remove a soft corn, separate the toes with the 
fingers of the left hand, after the proper preparation of 
the foot, as described before, and remove the thick 
cuticle with the scissors, being careful not to make the 
parts bleed. 

But a better or more scientific method is to employ a 
Toe Expander, which holds the toes apart, leaving both 
hands of the operator free to work with. The instru- 
ment, which is cheap, is so made that it can be held in 
position with a set screw ; it is shown in Fig. 41. 

Quite often the soft corns, if allowed to remain, will 
cause a blister to form beneath, which is broken by 
friction, creating a painfully exposed area of true skin. 
In this event, the edges of thickened cuticle are cut 
away with the scissors, and an antiseptic dusting pow- 
der, such as aristol, sifted upon the wound to heal it. 

After the removal of a soft corn, a Felt Disc or 
Washer is to be applied over it to prevent further fric- 



Chiropody 43 



tion or pressure. An old shoe should be worn several 
days until the parts have returned to a normal state. 




Fig. 41 
TOE EXPANDER 

If the feet perspire very freely, a condition often 
accompanying the presence of soft corns, they should 
be treated as later described. (See Perspiring Feet on 
page 58.) 

Vascular Corns. — This form of corn is not com- 
monly encountered. Such corns are found mostly upon 
the sole of the foot, either under the heel or the ball of 
large toe. They resemble a wsLVt, somewhat, and are 
composed of a number of small blood vessels from which 
they get their name. 

These corns are of a spongy nature, lying deep in the 
skin and very little above it. 

There may be a number of these vessels visible in 
the form of little red spots. 

The skin about the com is usually inflamed and 
tender. 

The treatment for such corns is as follows: Prepare 



44 The Care of the Foot 

the foot by bathing as for the removal of other corns, 
then carefully cut away with the corn knife or a corn 
file the upper surface, taking care not to incise or cut 
the veins. If the veins lie too near the surface to do 
this, or if a vein is cut in the paring treatment, touch 
the bleeding point with the dry tip of a lunar caustic 
pencil, or with a little nitric acid, applied with a wooden 
tooth pick. If the acid is used, be careful not to get it 
on the surrounding skin. 

This at once causes the vessel to stop oozing, but 
nothing must be attempted further until healing has been 
established. 

If there are a number of such red points showing, it 
is best to treat with nitric acid, applied to each spot 
with a toothpick. This is to be repeated every other day. 
In the meantime, place a chamois or a felt disc about 
the com, in the manner previously described, to re- 
lieve pressure. Loose shoes are also advised. 

After a number of such treatments, the corn will be 
found to grow smaller, or to shrivel up, finally disap- 
pearing altogether. The inflammation of the skin usu- 
ally subsides in one or two days, if pressure on the 
foot is relieved as directed. 

The discs of chamois or felt should be worn over the 
site of the corn for several weeks, even if there is no 
sign of the corn, to prevent its return and to give the 
skin an opportunity to become normally thick again. 

Callosities or Callous Skin. — This is a common 
condition of the feet, and is due to the friction of ill- 
fitting shoes. It usually appears in spots about the sole 
of the foot, at the heel, or the ball, or at both places. 
There may be one or more of such areas of thickened, 
horny skin closely grouped. 



Chiropody 



45 



To restore these painful surfaces to a proper state 
the foot is bathed as described heretofore. When dried, 
the foot is taken between the fingers and the thumb of 
the left hand, and the skin is pared or shaved off care- 
fully with the scalpel, held in the right hand, as shown 
in Fig. 42. 




rv^ 



Fig. 42 
REMOVAL OF CALLOUS SKIN 

Do not cut carelessly, or too deep. Avoid wounding 
the skin. Pare the callous down until the surface looks 
pink and is thin to the touch. 

It is well now to apply some antiseptic lotion, such as 
listerine, or witch hazel. Allow this to remain on and 
dry in, as it were. Dust on some stearate of zinc and 
cover over the surface with a fairly thick layer of ab- 
sorbent cotton. Over this lay a two-ply piece of borated 
gauze and hold the whole in position with strips of rubber 
adhesive plaster. 



46 The Care of the Foot 

Advise the patron to wear a loose shoe. Owing to the 
movement in walking, these dressings are likely to be 
displaced and need to be renewed every day. 

After the skin has taken on a more normal appear- 
ance, apply borated white vaseline to the area with a 
thin layer of cotton over it, and with gauze held in place 
by plaster strips. This tends to help nature restore the 
skin and to keep it soft and pliable at the same time. 

Onyxis^ or Ingrowth of the Toe Nails. — This ex- 
tremely painful condition is due to the careless cutting 
of the toe nails and the wearing of shoes narrow at the 
toes, or of shoes that, while broad enough, may press 
down too closely on the toes. The outer or inner sides 
of the great toe nail are usually affected, although any 
toe may be. 

The skin of the sides of the nail, having been pinched 
against the nail edge continuously for weeks or months, 
soon rises over the nail and becomes thickened and 
swollen. Eventually the nail cuts into the groove thus 
formed, causing the most excruciating pain upon walk- 
ing or even when standing quietly. 

Some persons have a tendency toward ingrown nails 
because of the natural curvature of the nails, which, not 
being trimmed properly, soon grow down into the cuticle. 
It is therefore necessary in all cases to look very care- 
fully to the trimming of the nails. The dry scales of 
cuticle should be removed from under the edges of the 
nail. The nail should be cut square across at its free 
end, and if, owing to a natural curvature of the nail, 
the edge tends to turn down at the sides, they should be 
elevated as hereafter described, and kept in this position 
until the nail ceases to curve downward. In the mean- 
time the centre of the nail from the cuticle to the outer 



Chiropody 47 



edge should be filed down. This tends to raise the sides 
of the nail. 

Another method is, to cut a V-shaped piece out of the 
free edge of the nail. In doing this, care should be 
taken not to injure the tender skin under the nail. The 
filing down of the nail is shown in the dotted lines and 
the V-shaped cut in dark outlines in Fig. 43. 




Fig. 43 
FILING THE NAIL 

If the nail sides have already curved downward, the 
dead scales of cuticle are removed carefully from under 
the edges with a pointed orangewood stick. This is fol- 
lowed with a packing of absorbent cotton, that should 
be allowed to remain there for twenty-four hours or 
two days, when it must be removed and replaced. This 
procedure should be continued until the nail has taken 
qn a normal growth. 

If inflammation or wounding of the skin has taken 
place, the treatment must vary accordingly. The foot 
should be bathed in hot water to which a tea spoonful 
of borax has been added. This softens the nail and 
skin and is antiseptic as well. The foot is now dried, 
and the parts about the ingrown nail are washed with a 
swab of cotton, dipped into listerine or alcohol, or into 



48 



The Care of the Foot 



a solution of peroxide of hydrogen and water, equal 
parts. 

The latter is especially useful, if pus has appeared at 
the seat of irritation. 

The peroxide will cause foam to appear at the site 
of the wound. This is washed off with listerine, and 




Fig. 44 
INSERTING COTTON UNDER NAIL 

the edge of the nail is pried up gently and out of the 
inflamed groove. This will be found to be very painful, 
and the entire lifting may not be accomplished at the 
first sitting. If not, it should be repeated the next day — 
and daily thereafter until the nail edge lies free above 
the skin. In the meantime, a piece of absorbent cotton 
is packed under the edge of the nail to keep it raised. 
The method of introducing this is shown in Fig. 44. 



Chiropody 49 



A little zinc ointment should be applied to the inflamed 
skin and groove, to heal the parts. All pressure at the 
side of the toe should be avoided. 

Another good method is to use a thin wedge of cork, 
which has been dipped into a weak carboHc acid solution 
before using. Two drops of carbolic acid to the ounce 
of water will answer very well. The advantage of the 
cork is that, as it becomes moist, it swells gradually and 
this raises the nail edge. This should be renewed every 
second day. 

Either of the treatments is, of course, to be continued 
until a cure has been established. If in the meantime 
the edge of the nail appear rough or sharp, it should be 
trimmed of its jagged edges, which will give a great 
deal of relief. But much cutting is not advisable, since 
it tends to make the nail grow thick in some cases, and 
brittle in others. 

The nail during treatment should be filed down thin 
along its centre, and the V-shaped cut be continued and 
made as shown in Fig. 43. 

If the ingrown nail has caused too much skin dis- 
turbance, indicated by the parts being highly inflamed 
and swollen, and the nail edge has become so deeply 
buried that it will be found useless to pry it upward 
without causing damage to the toe, the patron should be 
advised to see a surgeon for a permanent operation in 
order that complete relief may be secured as quickly as 
possible. 

Bunions. — If the foot has been subjected to the con- 
tinuous pressure of a short or a too narrow shoe for a 
long time, it often happens that the skin over the second 
joint of the great toe at its outer side becomes inflamed. 
This may also happen on the outer side of the same joint 



50 The Care of the Foot 

of the small toe, or both great and small toes may be 
involved. This condition is, however, most commonly- 
found in the large toe. 

If this inflammation is not relieved, it leads, at first, 
to the formation of a callous, which, by the continued 
pressure, causes irritation of the bursa^ or little sac that 
covers the joint cushion-like, to protect its delicate joint 
lining. 

The inflammation under consideration at first leads 
only to a callous formation, disappearing in from three 
to four days when the cause is removed, but necessarily 
recurring at short intervals if the proper shoe is not 
placed upon the foot, and eventually leading to a thick- 
ening of the entire tissue about the joint, and then to 
an enlargement of the joint, and ultimately to a partial 
dislocation of the joint, the toe being thrown inward 
and forward, disfi.guring the entire foot. 

This condition must not be confounded with gouty or 
rheumatic disease. The history of the bunion is quite 
easily followed, and the gradual development of the en- 
largement, with spasmodic inflammation following the 
wearing of new or tight shoes, should convince the pedi- 
curist of the correctness of his diagnosis. 

The early relief and obliteration of a bunion is a simple 
matter, but once it has become chronic little can be done 
as a rule to give permanent relief except a surgical op- 
eration. 

Given an early case of bunion during the stage of in- 
flammation, all causes of pressure must be removed. 
Shoes of ample length and width across the ball of the 
foot should be advised at once. The foot should be 
bathed in hot water for fifteen to thirty minutes to reduce 
the inflammation, and a soothing lotion be applied over 
night to relieve the pain and swelling. 



Chiropody 51 

The following should be painted upon the part several 
times a day with a camel-hair brush : 

B Tincture of Iodine 2 dr. 

Carbolic Acid 2 dr. 

Glycerine 2 dr. 

Or, if the pain is very marked, the following may be 
employed with better result: 

B Tincture of Belladonna 2 dr. 

Tincture of Iodine 2 dr. 

This is painted about the joint at least three times a 
day. 

After the bath, usually given at night, all callous skin 
and the small corns about the size of a split pea that are 
so commonly found about the enlarged joint should be 
trimmed away with the knife before the application of 
either of the above recipes is made. 

If, by any chance, the skin is wounded, neither of 
these lotions must be used. 

In such case, where the inflammation is moderate, a 
paste made as follows will be found to give relief : 

^ Zinc Oxide Powder 2 dr. 

White Vaseline 2 dr. 

Rub the vaseline and the zinc together well to make a 
smooth mixture. Apply to joint with two folds of gauze, 
over which place a layer of absorbent cotton, which 
must be held in place with strips of adhesive plaster. 

Shoes should not be worn at any time during such 
treatment, or, if they must be, that part of the shoe over 
the toe joint should be cut out to relieve all pressure. A 
heavy stocking should then be used to cover the dressing 
just mentioned. 

Hot or cold applications of witch-hazel at night often 
give excellent results in mild cases. 



52 



The Care of the Foot 



Once the inflammation, swelling and pain has subsided, 
do not let the patron wear a shoe without encircling- 
the site of the bunion with a ring of felt, or chamois, 
to prevent further pressure on the part. See Fig. 45. 

The faithful use of such a protective, and the wearing 
of proper shoes will usually effect a cure, if the case has 
been seen early enough. 

If the case has become chronic or an abscess has devel- 




Flg. 45 
APPLYING BUNION SHIELD 

oped, a great deal of attention is required, and in most 
cases the services of a surgeon are necessary. 

In case an abscess has formed, it is well to poultice the 
part with a flaxseed meal poultice, applied hot, at short 
intervals, until the skin becomes thinned out by the press- 
ure of the pus, when it should be opened and the pus let 
out. The small lancet with which the incision is made 
should be sterilized both just before and after each op- 
eration by dipping into a little jar of sterilizing fluid. 

The wound is washed with equal parts of peroxide of 
hydrogen and water, after which aristol powder is dusted 
on. Over this, lay two plies of gauze covered with ab- 



Chiropody 53 



sorbent cotton and a bandage to prevent infection or 
injury. This dressing is to be renewed each day. 

Once the parts are healed, a protective bunion-shield 
or ring must be placed over the affected parts until re- 
covery is confirmed beyond a possibility of relapse. 
Proper shoes, of course, are to be worn. 

For dislocation of the toe, and enlargement of the 
joint, nothing but surgical intervention will be of any 
use. The patron m^ust in this case be referred to a skilful 
physician or specialist. 

Flatfoot. — ^When the arch of the foot becomes weak- 
ened or broken down, the sole of the foot, instead of 
being arched between the ball and heel of the foot, be- 
comes flat or sprawled. 

This condition is becoming more and more marked in 
modern times, due principally to the wearing of im- 
properly made shoes. 

High heels are a cause to a great extent, as well as 
improperly balanced shoes with little or no support un- 
der the arch. 

It is also caused by continuous standing, or by ex- 
cessive walking or by adiposity. Even moderately stout 
persons are very liable to become victims of this afflic- 
tion. Long-continued confinement to the bed, as during 
a protracted illness, or general weakness, are also causes. 
In such cases, the muscles of the leg having become 
weakened, the whole weight of the body falls upon the 
body structure of the foot, and causes it to give way. 

Children who are taught to walk too early in life often 
become flatfooted. 

The loss of the arch of the foot may occur at any time 
in life, and as often in men as women. It may be found 
more often with the former, however, in certain locali- 



The Care of the Foot 



ties, where a man is subjected to long periods of work 
in a standing position, and eats improper or poorly 
cooked food. Low vitality and poor environment may 
be stated as very common causes. 

The early symptoms of flatfoot are rather uncertain. 
There is no sign of inflammation about the feet. The 
patron complains of pains in the feet, a dull aching in 
the calves of the legs, and of becoming easily tired on 
standing or walking. 

On examination the arch may seem to be as shown in 
Fig. 2y, but as these symptoms continue to grow worse, 
and walking becomes a burden, the arch will be seen to 
fall lower and lower, until the entire sole of the foot 
falls flat upon the floor as shown in Fig. 28. 

Once this condition has resulted, there is little possi- 
bility of restoring the arches to the normal position. 

Cases must be recognized and treated early, in order 
to attain any marked relief, and, unfortunately, the pa- 
tients will not often present themselves until too late. 

Early in the disease, the feet should be bathed nightly 
in a hot bath to which a handful of sea-salt has been 
added. The bath should last about fifteen minutes. After 
thoroughly drying the skin, rub the feet with alcohol and 
have the patient go to bed so as to remove all strain 
from the feet. 

Properly fitted shoes must now be provided. The 
heels should not be high, for, while very high heels at 
first seem to give relief, they only hasten the final ruina- 
tion of tiie arch. Laced shoes, because they can be more 
simply applied to the feet, are best. 

Artificial Arches. — Arches of steel covered with 
leather have been much in vogue. They are bad. Arches 
of cork with a small steel spring have been tied to the 



Chiropody 55 



feet and worn inside of the shoes, and are much better, 
but the cork becomes damp and swells and rots. If a 
glove of some kind that would resist dampness were 
put over them in making, the cork arches would be pref- 
erable for many feet. The arches now most in use and 
most advisable are of hard rubber with a small steel 
spring. These have a considerable elasticity, which the 
steel arch lacks, but they are liable to snap. These arches 
should be worn but an hour or two during the first and 
second week especially, because if they force the arch 
up abruptly they will cause great pain. They should 
be worn a few hours each day until the feet have become 
accustomed to them and the bones have begun to as- 
sum a position near that of the original. 

In such cases, these arches should not be given up 
for years, inasmuch as the old trouble is apt to recur. 

In severe cases a flannel bandage should be put on the 
feet after the bath at night ; or Faradic electricity for ten 
minutes be applied to the feet before the bandages. These 
bandages are to be removed in the morning and proper 
shoes with arches worn. The sufferer should avoid 
standing for any length of time, and rest the feet as 
much as possible. 

The treatment just suggested should be repeated every 
other day for several months to gain any benefit. 

As a rule, all treatment in chronic cases gives only 
relief, since the arches once entirely broken down can 
rarely be replaced. The patron is therefore compelled 
to treat the feet with continuous care for the rest of life. 
If he or she can be taught by the chiropodist to realize 
early the importance of wearing sensible, well-fitting 
shoes and to adopt the use of proper arches therein, much 
good will result, because much ill will be escaped. Neg- 
lect of flatfoot eventually leads to intense physical pain 



56 The Care of the Foot 

and mental anguish that at times seems almost unbear- 
able. Therefore, if you have cause to suspect from an 
examination of a patron's feet that flatfoot is likely to 
come, or if the stoutness of your patron indicates a lia- 
bility to a sudden attack of it, advise earnestly against 
the dangers of neglect. The gratitude of an intelligent 
patron whom you have saved in time, or whose feet you 
have set right in the early stages of this com^mon malady 
is often very great and constant. 

Chilblains. — Some persons are especially susceptible 
to frost bite or chilblains of the feet. Lowered vitality, 
snow water, severe cold and too quick heating of cold 
feet are the usual causes of chilblains. 

At the first symptom, which is usually an itching of 
the foot, applications of olive oil or almost any handy 
grease should be put on without much rubbing. After 
the grease has been gently manipulated into the skin 
and between the toes, the surplus may be wiped off to 
avoid too much soiling the stockings. Care must be 
exercised to keep the feet dry, that is, thoroughly wiped 
or patted dry after bathing and wiped dry and the stock- 
ings frequently changed if the feet perspire. 

Some persons appear to be particularly susceptible to 
chilblains, even a chill dampness causing the condition. 

In some cases, the frost bite results in the loss of one 
or more toes. 

When the case Is seen early the feet should either be 
rubbed with snow until the circulation is re-established, 
or be placed into a cold bath which is warmed gradually. 
Any sudden application of heat is to be avoided. Even 
the room in which the patient is to be treated should be 
cool, so as not to increase the general circulation too 
readily. 



Chiropody 57 

To relieve any further discomfort, after such a bath 
or snow rub paint the chilblains with pure guaiacol. 
Repeat the external use of this several times during the 
day. 

If the frost bites are not severe, they may be painted 
with equal parts of camphor and belladonna liniment, 
or with this : 

IJ Oil of Cajeput 2 dr. 

Strong Liquid Ammonia 2 dr. 

Compound soap liniment enough to make 3 ounces. 

If the skin over the parts has become cracked and 
sore, apply a soothing antiseptic ointment, such as the 
following : 

B Ichthyol 20 drops 

Zinc Oxide i dram 

White Vaseline 2 ounces 

Mix into an ointment, apply on pieces of lint, and cover 
with absorbent cotton, or this, applied by binding on the 
part absorbent cotton or linen bandages soaked in it : 

B Glycerine i 02. 

Tincture Iodine 20 gr. 

Tincture Opium 20 gr. 

To prevent further danger from frost bite, have the 
patient wear woollen socks or stockings. The use of 
an artificial perforated medicated insole is often helpful, 
as it also is in case of callosities, 

Us2 a hot footbath, to which a handful of sea-salt has 
been added, each night, and follow after drying with an 
alcohol rub. Spirits of camphor are also soothing, or a 
mixture of half alcohol and half spirits of camphor may 
be used after the bath. 

When there is intolerable itching or burning, this mix- 



58 The Care of the Foot 

ture applied on cotton or bandages to the parts often 
quickly soothes: 

B Burnt Alum 5 gr. 

Iodide of Potassium ^ gr. 

Laudanum 2 gr. 

Rose Pomade 5 gr. 

Lard {fresh} s gr. 

A so-called passive movement or treatment of the 
soles of the feet is to cross the foot over the opposite 
knee and with a ruler or short stick strike the sole of 
the foot a series of rapid light blows, about 30 or 40. 
The sole of the foot to be protected by a slipper. The 
benefit derived chiefly belongs to the capillaries and 
nerves of the part, the congestion of the capillaries, as 
in chilblains, is quickly scattered. The movement warms 
the feet and the cure of chilblains is often speedy and 
permanent. 

Avoid placing the feet upon oven-hot air registers, 
or putting them near to the fire. Improve the health 
by proper exercise and food. 

Perspiring Feet. — ^While perspiration of the feet is 
natural, excessive perspiration is a disease depending 
upon lowered nerve tone In the skin of the feet, or upon 
general poor health. 

To overcome the condition improve the health first 
of all by proper living and food, healthful exercise, and 
daily care of the feet as heretofore prescribed. 

For the sweating, the following powder will be found 
locally excellent: 

IJ Perborate of Soda i dr. 

Salicylic Acid 20 gr. 

Boric Acid (powdered) 2 03. 

Mix the powders together well and shake about a 
teaspoonful into the shoes each morning. 



■Mv 



Chiropody 59 



Change the stockings each day, as well as the shoes, 
wearing each pair alternate days. 
Another excellent powder is made of the following: 

IJ Alum (powdered) y2 os. 

Orris Root (powdered) i 

Rice (powdered) 2y^ " 

Mix well together and dust into the shoes as the above. 

The following, dusted on freely, will also be found 

excellent : 

FOR PERSPIRING FEET 

I^ Borax lo grams 

Starch lo 

Salicylic Acid 3 

Powdered Alum 5 

Talcum Powder 50 

Naphthol 5 

or this far simpler preparation often very quickly effect- 
ive, can be applied with a camel-hair brush or soft 
sponge : 

I^ Distilled Water ^ gf. 

Bichromate of Potassium lYz dr. 

Essence of Violet i dr. 

If the patient suffers from excessive ill-smelling sweat- 
ing of the feet, the following will be found highly sat- 
isfactory : 

"^ Bismuth Subnitrate ^202. 

Permanganate of Potash 6 dr. 

Rice Powder i 03. 

Mix well and dust into the stockings and into the 
shoes, following the same general directions for the 
proper care of the feet as heretofore given. 

Hot Feet and Cracks Between Toes. — If the cracks 
between the toes are caused by excessively hot feet, 
quick relief is obtained in most cases by a prompt appli- 



6o The Care of the Foot 

cation of zinc ointment over the cracked surfaces, or by- 
powdering thickly with Fuller's earth. 

If the feet are bathed nightly in tepid salt water or 
water into which a little borax has been sprinkled, there 
is little likelihood of sensitive swollen feet, or of hard- 
ened or calloused spots. Be careful when bathing the 
feet to dry between the toes thoroughly. 

Rub any swollen portions of the feet with witch hazel 
or alcohol, and any hard, calloused places with olive oil 
or cold cream. 



It! 



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A Practical Text-book on Chiropody and General Care of the Feet 

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